Advanced Courses

Preceptorship Courses

Apply now to join one of our Preceptorship courses!

Workshops & Courses

ESMO fosters the advancement of cancer research by supporting clinical trials workshops to inspire young oncologists from different disciplines across the globe to become the next generation of active researchers.

Patient Guides

Guides for Patients are designed to assist patients, their relatives and caregivers to better understand the nature of different types of cancer and evaluate the best available treatment choices

Personalised Medicine Explained

Video interviews and articles designed to help patients, policy makers and other non-medical professionals better understand the principles of personalised cancer medicine

Getting the Most out of Your Oncologist

Now available in Romanian, our Guide for Patients with Advanced Cancer is designed for patients, their family members and oncologists.

Designated Centres of Integrated Oncology and Palliative Care

The ESMO Designated Centres of Integrated Oncology and Palliative Care accreditation programme recognises cancer centres which provide comprehensive services in supportive and palliative care as part of their routine care.

EFPIA Disclosure Code

Policy News

Welcome to OncologyPRO, the home of ESMO’s educational and scientific resources, with Guidelines, a comprehensive list of E-Learning modules, Factsheets on biomarkers, slides and webcasts from our educational programme, and more... to support continuing medical education and daily practice!

New findings suggest why patients with early-stage tumours and EGFR mutations have worse outcomes with erlotinib

Mutations in the epidermal growth factor receptor (EGFR) are the most common actionable genetic abnormalities yet discovered in lung cancer. However, targeting these mutations with kinase inhibitors is not curative in advanced disease and has yet to demonstrate an impact on potentially curable, early-stage disease, with some data suggesting adverse outcomes.

The drug erlotinib is routinely used to treat advanced non-small cell lung cancers with a mutation in EGFR, but when the same drug is used for patients with early-stage tumours with mutation in the same gene, they actually fare worse. A study by researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) and at Cincinnati Children’s Hospital might show why.

The study shows that while erlotinib effectively causes tumours to shrink, this drug also increases the aggressiveness of the tumour so that growth is accelerated when therapy ends. This study finds that this is due to a secondary and previously unknown effect of inhibiting EGFR.

The researchers found that when erlotinib blocks EGFR, it activates a second signaling molecule, Notch3. Activation of that pathway leads to increased development of cancer stem cells among the surviving tumour cells and to accelerated tumour growth.

“Our findings might explain why erlotinib in clinical trials seems to worsen survival in patients with early-stage lung cancer,” says one of corresponding authors Dr David Carbone, professor of medicine, Division of Medical Oncology at the OSUCCC – James. “They also suggest that combining an EGFR inhibitor with a Notch inhibitor should overcome the effect.”

In two non-small cell lung cancer cell lines, treatment with erlotinib killed 84% and 75% of cells; of the surviving cells, 23% and 70% were stem-like cells, respectively (versus 4% and 18% of control cells);